| NPI | 1528300902 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUGUSTUS C SEALY Manager 508-752-5444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 3864) |
| Enumeration Date | 2013-03-23 |
| Last Update Date | 2013-03-23 |